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GHI Mid-Term Review and a Way Forward

As the Global Health Initiative moves into its third year of implementation, Nandini Oomman and Rachel Silverman summarize the current status of this major development initiative, highlight the challenges for the GHI, and propose specific recommendations for a way forward.

The GHI, announced in May 2009, presented a new way for the United States to do business in global health. The Obama administration argued that the country’s fragmented global health architecture generated inefficiencies and duplication and hindered efforts to maximize program impact and strengthen health systems abroad. The new administration launched the GHI to consolidate global health programs under a single banner and dismantle existing vertical structures in favor of an integrated, cooperative approach.

At its launch, the GHI was met with great excitement and showed much promise as a coordinating mechanism to streamline U.S. global health funding and improve aid effectiveness. Thus far, however, the initiative has been plagued by problems with transparency, leadership, coordination, funding, and implementation, leading to deep skepticism both within and outside the U.S. government.

Oomman and Silverman present several options to help GHI regain the promise it held. Most important, the Obama administration needs to quickly clarify its calibrated vision of the GHI, and then clearly articulate that vision to stakeholders.